Covid contact tracing brigades in France: What we know
France is to have “brigades” of people who will trace contacts of people who test positive for Covid-19 after confinement ends, to help contain further spread of the virus. Here is what we know about them so far.
Prime minister Edouard Philippe made the announcement as part of his speech on Tuesday April 28.
He said: “[We want to] protect, test, isolate. In each department, we will have brigades whose job it is to compile a list of contacts, and to call them, to invite them to be tested, telling them where to go for a test, and then to check that these tests have indeed been done.”
This will allow people to “identify the carrier of the virus and break the chain of infection”.
How will the “brigades” work?
They will be people tasked with “investigating” the contacts of patients who have tested positive for the virus. This will include anyone who has been in sufficient contact with the infected person, outside of the home, during this period, including 48 hours before any symptoms first appeared.
The brigade will then question each contact - generally by phone - within 48 hours, to know how or if they were with the infected person while they were contagious.
These contacts will then be reminded to respect all the health recommendations and barrier advice. In some cases, they will themselves be advised to get tested.
In some cases, teams may even visit people’s homes to test an entire household on-site.
What will the questions involve?
Mohamed Azgag, director general of health insurance office la CPAM in Morbihan (Brittany), explained to news service FranceInfo: “[The brigades] will follow precise criteria, with a list of questions created by Santé Publique France.”
They will include questions on details such as: “How long were you speaking? How far away were you? Were you or they wearing a mask?”
But cooperation with the brigades will not be “obligatory”, said Etienne Moulin, president of departmental doctors’ council, le Conseil de l'Ordre des Médecins du Tarn (Occitanie).
He said: “If someone doesn’t want to speak about their contacts, we can’t really do anything. We are not in China.”
However, a new law will be put in place to allow the brigades to carry out their work, Mr Philippe has said.
How will these brigades be put together?
It is not yet 100% clear how this will be done, but what is certain is that the scheme will require a lot of people.
In its update from April 20, government scientific advisory council le Conseil Scientifique said that at least 30,000 people would be needed for the task, given the size and population of the country.
This may include - but not exclusively - medical insurance staff, social security staff, GPs, healthcare workers, relevant association workers, and health services connected to local Mairies.
In South Korea, where a similar system was put in place at the start of the epidemic, there were 20,000 people working as part of these “brigades” - for a population of 52 million, compared to 67 million in France.
Does this contact tracing system work?
It is known to be a proven method to help stop the spread of infection, according to le Conseil Scientifique.
It said: “The use of such a method allowed for the control of epidemics such as SARS (severe acute respiratory syndrome), MERS (Middle East respiratory syndrome), and Ebola. [It] has shown its effectiveness on the ground in South Korea, but also in Norway.”
A similar method was introduced by Santé Publique France at the start of the Covid-19 epidemic, to try to trace contacts of the first people infected, in the commune of Contamines-Montjoie (Haute-Savoie, Auvergne-Rhône-Alpes).
Yet, the scheme was abandoned when the country went into phase three of the epidemic, as advised by the World Health Organisation (WHO).
Certain conditions must be met to enable the method to work efficiently.
This includes having enough tests available, and enough people to take part in the brigade investigations.
The French government has admitted that sometimes, these investigations may not work “in urban centres, due to the impossibility of tracing the chain of infection in more densely-populated areas, especially on public transport”.
For example, if an ill person took the Metro, or waited for a long time in a supermarket queue, they may have accidentally been in contact with people they do not know, which would make the tracing process even more difficult.
How does the StopCovid smartphone app fit into this?
Other countries - such as Singapore and South Korea - have already made use of an app to help trace contacts, but have used them in tandem with investigation teams similar to those planned for France.
In France, the app - which is not yet being used - is not intended to work alone. It is instead intended to work as another part of the wider strategy, especially when it comes to tracing people that the infected person does not know.
However, it appears less-and-less likely that the app will be available and/or functioning by May 11.
Mr Philippe told MPs: “I am not currently able to tell you if [the app] works, and exactly how it will work.”
In South Korea, the government also introduced the tracing of contacts through their mobile phones; a step that has so far been resisted in France, with critics saying that this would not be ethical.
Mr Philippe has promised that the Assemblée Nationale will have a chance to debate and vote on the use of the app in the near-future.
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